Evidence map›Paper›PMID 38958545›Full record

ArticleCritical care explorations2024

Actual Cost of Extracorporeal Cardiopulmonary Resuscitation: A Time-Driven Activity-Based Costing Study.

Vinodh B Nanjayya, Alisa M Higgins, Laura Morphett, Sonny Thiara, Annalie Jones, Vincent A Pellegrino, Jayne Sheldrake, Stephen Bernard, David Kaye, Alistair Nichol and 1 more

Abstract read
In one paragraph

Article in Critical care explorations, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Vinodh B NanjayyaIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.
Alisa M HigginsAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Laura MorphettPerformance Analysis and Reporting Department, Alfred Health, Melbourne, VIC, Australia.
Sonny ThiaraDivision of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, Vancouver, BC, Canada.
Annalie JonesIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.
Vincent A PellegrinoIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.
Jayne SheldrakeIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.
Stephen BernardIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.
David KayeDepartment of Cardiology, Alfred Hospital, Melbourne, VIC, Australia.
Alistair NicholIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.
D James CooperIntensive Care Department, Alfred Hospital, Melbourne, VIC, Australia.

Funding

Australian Resuscitation Council Victoria Branch
6 · The paper itself

Abstract

objectivesTo determine the actual cost and drivers of the cost of an extracorporeal cardiopulmonary resuscitation (E-CPR) care cycle. PERSPECTIVE: A time-driven activity-based costing study conducted from a healthcare provider perspective.

settingA quaternary care ICU providing around-the-clock E-CPR service for out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) in Australia.

methodsThe E-CPR care cycle was defined as the time from initiating E-CPR to hospital discharge or death of the patient. Detailed process maps with discrete steps and probabilistic decision nodes accounting for the complex trajectories of E-CPR patients were developed. Data about clinical and nonclinical resources and timing of activities was collected multiple times for each process . Total direct costs were calculated using the time estimates and unit costs per resource for all clinical and nonclinical resources. The total direct costs were combined with indirect costs to obtain the total cost of E-CPR.

resultsFrom 10 E-CPR care cycles observed during the study period, a minimum of 3 observations were obtained per process. The E-CPR care cycle's mean (95% CI) cost was $75,014 ($66,209-83,222). Initiation of extracorporeal membrane oxygenation (ECMO) and ECMO management constituted 18% of costs. The ICU management (35%) and surgical costs (20%) were the primary cost determinants. IHCA had a higher mean (95% CI) cost than OHCA ($87,940 [75,372-100,570] vs. 62,595 [53,994-71,890], p < 0.01), mainly because of the increased survival and ICU length of stay of patients with IHCA. The mean cost for each E-CPR survivor was $129,503 ($112,422-147,224).

conclusionsSignificant costs are associated with E-CPR for refractory cardiac arrest. The cost of E-CPR for IHCA was higher compared with the cost of E-CPR for OHCA. The major determinants of the E-CPR costs were ICU and surgical costs. These data can inform the cost-effectiveness analysis of E-CPR in the future.

Indexed as

Cardiopulmonary ResuscitationExtracorporeal Membrane OxygenationOut-of-Hospital Cardiac ArrestAustraliaCosts and Cost AnalysisFemaleHealth Care CostsHeart ArrestHumansIntensive Care UnitsMaleMiddle AgedTime Factors

Identifiers

PMID38958545
PMCPMC11224838

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.